Personal Information

Family/Last Name or Surname:

First or Given Name:

Preferred Name:

Former last name if different from current:

Overseas Current Mailing Address:
Street address
City
County
State
Country
Postal Code
* Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form.

Permanent or Summer Mailing Address:
Street address
City
County
State
Country
Postal Code
* Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form.

Gender: Male Female

Date Of Birth:

Email Address:

Home Phone:

Alternate Phone:

Cell Phone:

Have you previously applied to Carson-Newman College:
Yes No
If yes, and admitted please list Term/Year:


Enrollment Plans

Major:

Year plan to Enroll:

I plan to Enroll as a:

I am applying for a full course of study (12 or more hours) to begin in one the following terms:
if selected other term:

If you are applying for a course of study less than 12 hours please list:
Course Name & Description

I am applying for admission to the:
if selected other:

I plan to (check one of the following):

ELI
Complete the ELI program
Complete the ELI program and pursue further studies at C-N
Attend one ELI term Spring
Attend one ELI term Fall
Attend one ELI term Summer

Undergraduate
Complete an undergraduate program (Receive a Degree)
Attend one undergraduate term Spring
Attend one undergraduate term Fall
Attend one undergraduate term Summer

Transfer
Transfer credits from a past or current university/college to
Complete an undergraduate program (Receive a Degree)

Post-Bac Undergraduate
Complete a Health Pre-Professions undergraduate program
Complete a Pre-Engineering undergraduate program
Complete a Pre-Law undergraduate program

Re-Admit
Re-Admit into an undergraduate program
Re-Admit into the ELI program
Re-Admit into into Post-Bac program as a graduate of C-N:
Date of Graduation from CNC

Other Program
Attend a special program not listed above:


Family Information

Please provide two different contacts below

Contact 1

Father Mother Spouse USA Contact

Last Name:

First Name:

Mailing Address:
Street address
City
County
State
Country
Postal Code
* Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form.

Email Address:

Home Phone:

Alternate Phone:

Cell Phone:

Contact 2

Father Mother Spouse USA Contact

Last Name:

First Name:

Mailing Address:
Street address
City
County
State
Country
Postal Code
* Please contact Office of Admissions (Coordinator of International Enrollment) if this address changes by submitting a change of address form.

Email Address:

Home Phone:

Alternate Phone:

Cell Phone:

Will you bring any dependents (spouse or child) with you?
Yes No
If yes, please include their names, counties of citizenship, dates of birth, and relationship to applicant:

I plan to live On Campus Off Campus
Please be advised that if you choose to live off campus, Carson-Newman College is not responsible for finding you housing.


Travel Documents

Passport Number or United States Social Security Number (if a US Citizen):

Country of Origin/Birth:

City of Birth:

Countries of Citizenships:

Country of Legal Permanent Residence:

Do you currently possess an immigration visa? 
Yes No
If yes:

Date Of Issue: Date Of Expiration:
Port of Entry: Date of Entry:

If you are currently in the U.S.  on a Non-immigrant Visa other than a F-1, please indicate if you would like to apply for a change of status to an F-1 Student Visa? 
Yes No

If you are currently in the U.S. on an F-1 Visa, please list below the name of the U.S. institution issuing your current Form I-20//DS-2019:


Educational Information

What type of diploma did you most recently receive? (In original language):

Native Language (List all that apply):

Primary language spoken at home (List all that apply):

Languages spoken (List all that apply):

Are you currently enrolled in the Carson-Newman College English Language Institute?
Yes No

If you have taken the TOEFL/TWE, IELTS or STEP please list: 
Test Name:

Date taken: Score:
Please note only official scores sent from a testing center will be accepted for application.

Do you wish to take the Carson-Newman College English Language Placement exam in place of the required TOEFL, IELTS, or STEP exam?
Yes No

If you attended high school overseas, what type of exams did you sit?

High school or secondary school from which you graduated or will graduate:

School Name

Country code/City code/School Number

City, State
Country
Date of Graduation (month/year)

Please list honors/awards received and extracurricular activities:

College/University Information (List All that Apply):

Institution City, State, Province, Country

Date of Attendance  (month/year to month/year)

Degree Earned

Approximate number of hours:


Additional Student Information

T-shirt size:

How did you hear about Carson-Newman College?

Do you have relatives who attend or have attended Carson-Newman College?
Yes No
If so, what is the relationship to you?

If not with both parents, with whom do you make your permanent residence?

Are you preparing for a full-time Southern Baptist church related vocation?
Yes No

Are you a dependent of a full-time or bi-vocational Southern Baptist minister/missionary?
Yes No

Please explain any special circumstances that should be taken into consideration when reviewing your application for financial assistance:

Are you currently on probation, parole, or under court restriction, or have you ever been convicted of a criminal offense other than a minor traffic violation?
Yes No

Has any academic or disciplinary action been taken against you at any college or university previously attended? 
Yes No

If you answered yes to either question, please submit explanation with this application:

 

I hereby certify that all information given on this application is true and correct.  Upon my acceptance, I agree to comply with all rules, regulations, and policies of Carson-Newman College as stated in the college catalog and student code of conduct.  Failure to comply with college policies may result in disciplinary actions.

By clicking the submit button, you agree that you  have read, understood, and agreed with the above statements.